HomeMy WebLinkAbout386_Arlington-Application-for-PACCIVIL (TYPE I) ❑
TYPE I &II ONLY
Protect Name:6025029
CONSTRUCTION PERMIT APPLICATION
Community & Economic Development
City ofArlington • 18204 59th Avenue NE • Arlington, WA 98223 • Phone (360) 403-3551
GRADING/PAVING/DRAINAGE (TYPE II) ❑ RIGHT OF WAY (TYPE III)
NEW DEVELOPMENT ❑ REDEVELOPMENT ❑
Snohomish County Tax Parcel I.D. #: N/A - ROW WORK
,Project Address/ Location: 8927 172nd St NE, Arlington, WA 98223
Description of Project: Place new 3x5 HH 10' from base of Pole 44, trench 10', place new conduit,
perform riser work, overlash to Pole 265746 and Pole 265743, splice, and pull through existing conduit.
OWNER
Name:Ziply Fiber Northwest, LLC
Address: 426 E Casino Rd.
city: Everett State: WA
Zip: 98208
Phone: 402-670-8384
Email: r atco ermits zi I .com
APPLICANT
Name: Ziply Fiber Northwest, L L C
Address: 426 E Casino Rd.
City: Everett State: WA
Zip: 98208
Phone: 402-670-8384
Email: grpatcopermits(@ziply.com
ENGINEER
_
Name: Wayne Wendell
Address: 426 E Casino Rd.
city: Everett State: WA
zip: 98208
Phone:360-757-3406
Email: wa ne.wendell zl I .com
License#:
Expiration:
CONTRACTOR
Name: Pacific Cable Construction, Inc.
Address:P.O. Box 573
Citv: Woodinville State: WA
Zi :98072
Phone:425-348-7735
Email: Luke-@-.oaccab.com
License#: P A C I F C C 9 5 4 P Expiration:
I hereby certify that I have read and examined this application, City of Arlington Municipal Code, Standard Plan & Specifications. Performance of the
proposed work shall follow all applicable laws and regulations. The owner/applicant shall assume full and complete responsibility for said work and shall
be responsible for the acquisition and compliance of all applicable pemlits and/or authorizations which may include, but not limited to, Right of Wiry
Penuit, WSOW Hydraulic Project Approval (HPA), WSDOE Notice of Intent (NOi), National Pollutant Discharge Elimination System (NPDES), Anny Corp. of
Engineers P,.,'pl the requirements oft1le Endangered Species Act; and the Forest Practices Application (FPA).
Signature Y ! 4 �G.�7`_
----------------------------- -
Print NameTikaru Saito
Date: 5/6/2026
Page 1 of2 REVII/2018
.Complete package constitutes all items. Only complete submittals will be accepted._
Civil - Submittal Requirements, Type I:
D Complete Application;
D Construction Plans including cut / fill quantities;
. 2 full size plan sets 22" x 34"
• PDF file of the complete plan set
. 2 full size set of landscape plans 22" x 34"
D Marysville Utility plans, ifapplicable (2 sets);
D Drainage Analysis including calculations and downstream analysis (2 sets) and (PDF file); refer to Stormwater Drainage
Requirements;
D Geotechnical Report (2 sets) and (PDF file);
D SEPA is required if 500 or more cubic yards of cut/ fill is proposed (not required if included with a Land Use Permit);
D Grading cut/ fill quantity: --------
D Design Vehicle - demonstrate turning radius include 45' Fire truck, dual axle, 256 inch wheel base;
D Complete Streets Checklist
D Drafts of easement(s) dedication(s), and/or CAPE(s) for review;
D Flood Hazard Permit Application and required documentation if project is within 100 year flood plain; refer to Flood
Hazard guidance documents;
D Construction Calculation Worksheet;
D NPDES Permit (if required); See Storm Water Drainage Report, New or Redevelopment Flowcharts,
D Assurance Device will be required prior to Permitlssuance (Bond or Assignment of Funds);
D Permit Fee due at time of permit submittal.
Grading/ Paving/ Drainage Submittal Requirements, Type II:
D Complete Application;
D Construction Plans including import/export quantities;
. 2 full size plan sets 22" x 34"
. PDF file of the complete plan set
D Drainage Analysis including calculations and downstream analysis (2 sets) and (PDF file); refer to Stormwater Drainage
Requirements;
D Geotechnical Report (2 sets) and (PDF file);
D SEPA is required if 500 or more cubic yards of cut/fill is proposed (not required if included with a Land Use Permit);
D Grading cut/ fill quantity: ---------
D Construction Calculation Worksheet;
D NPDES Permit (ifrequired); See Storm Water Drainage Report, New or Redevelopment Flowcharts,
D Permit fee due at time of permit submittal.
Right of Way Submittal Requirements, Type III:
Complete Application;
5Q Construction Plans;
Traffic Control Plan;
❑ Road dosure Request;
❑ Temporary Erosion & Sediment Control (TESC) Plan;
❑ Certificate oflnsurance with the City ofArlington named as Additional Insured;
❑ Assurance Device will be required prior to Permit Issuance (Bond or Assignment of Funds);
Engineers Estimated Cost of Construction; $_ _ _ _ _ _ _ _ _ _ _ _
QI Permit fee due at time of permit issuance.
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